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General NPI Number Information
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NPI Number | 1972417673
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Entity Type | Organization
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Legal Business Name | LOWCOUNTRY CHILDREN'S GENERAL ANESTHESIA DENTISTRY, LLC
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 1858 REMOUNT RD
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City | CHARLESTON
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State | SC
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Zip | 29406-3270
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Country | US
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Telephone | 301-494-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 1220 CARAWAY CT STE 1050
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City | UPPER MARLBORO
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State | MD
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Zip | 20774-5338
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Country | US
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Telephone | 301-494-3000
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JEFFREY WHEELER
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Credential |
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Telephone | 301-494-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State | NULL
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